=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972580397
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES E LEMIRE MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/28/2005
-----------------------------------------------------
Last Update Date | 06/11/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9401 SW HIGHWAY 200 BUILDING 90
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34481-9612
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-291-9459
-----------------------------------------------------
Fax | 352-291-9465
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9401 SW HIGHWAY 200 STE 301
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34481-9648
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-291-9459
-----------------------------------------------------
Fax | 352-291-9465
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | ME0074505
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------